A debate over expanding Medicaid health coverage to up to 400,000 low-income Virginians is poised to dominate the General Assembly in 2014. Republicans are skeptical, Democrats enthusiastic, and now, a new proposal is shaking up the conversation.
Governor Bob McDonnell didn't include funding for expansion in his new budget, but did include a plan to stop it in 2016 as federal funding scales back. Some Democrats see that as a sign of optimism. But Republicans say not so fast.
It's a lightning rod for partisan bickering. Democrats say go for it - the federal government will cover 100 percent of the costs of expansion for the first three years, dropping down to 90 percent after that.
But House Republicans worry the feds will not be able to keep their financial promises.
"We don't feel comfortable with where the federal government is related to funding, and that hasn't gone away," said 25th District Delegate Steve Landes (R).
As Virginia's Medicaid Innovation and Reform Commission mulls whether to support expansion, Governor Bob McDonnell proposed a sunset clause Monday, to stop Medicaid expansion on June 30, 2016, as full federal funding scales back.
"That's also an opportunity to require a full evaluation of whether Medicaid reform efforts in Virginia are working, and whether or not Virginia can afford expansion," said McDonnell.
Democrats say it's an optimistic step toward expansion.
"I read it as opening the possibilities for Medicaid expansion, and a slight change in his position," said 32nd District Senator Janet Howell (D).
But Republicans say McDonnell's proposal changes very little.
"I'm not sure it's a solution, but at least it's a suggestion," said Landes.
But the battle is only just beginning. Expansion is one of Governor-elect Terry McAuliffe's biggest priorities, and neither side is letting go without a fight.
"We're going to work with him where we can," said Landes. "Medicaid expansion is an area we disagree with him on."
Medicaid expansion will likely be the biggest issue during the coming General Assembly session, but not all Republicans are turning their noses up at the idea. Augusta Senator Emmett Hanger wants to explore expansion ideas specifically tailored for Virginia.
The General Assembly reconvenes January 8.